Fig. 12
Severe retroperitoneal (type II) DP in an 80-year-old female following ERCP with sphincterotomy, incomplete removal of choledocholithiasis and positioning of a plastic CBD prosthesis (arrowhead). Post-procedural unenhanced CT viewed at both soft-tissue (a, b) and bone (c, d) window settings showed extensive retroperitoneal air (+) predominantly located in the right peri- and pararenal spaces, around the descending duodenum and tracking along the inferior vena cava and portal vein (thin arrows). Surgical exploration dictated by sepsis failed to detect a perforation site, and the patient recovered fully